The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours

Holger Moch; Mahul B Amin; Daniel M Berney; Eva M Compérat; Anthony J Gill; Arndt Hartmann; Santosh Menon; Maria R Raspollini; Mark A Rubin; John R Srigley; Puay Hoon Tan; Satish K Tickoo; Toyonori Tsuzuki; Samra Turajlic; Ian Cree; George J Netto

doi:10.1016/j.eururo.2022.06.016

The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours

Eur Urol. 2022 Nov;82(5):458-468. doi: 10.1016/j.eururo.2022.06.016. Epub 2022 Jul 16.

Authors

Holger Moch¹, Mahul B Amin², Daniel M Berney³, Eva M Compérat⁴, Anthony J Gill⁵, Arndt Hartmann⁶, Santosh Menon⁷, Maria R Raspollini⁸, Mark A Rubin⁹, John R Srigley¹⁰, Puay Hoon Tan¹¹, Satish K Tickoo¹², Toyonori Tsuzuki¹³, Samra Turajlic¹⁴, Ian Cree¹⁵, George J Netto¹⁶

Affiliations

¹ Department of Pathology and Molecular Pathology, University Hospital Zuerich and University of Zuerich, Zuerich, Switzerland. Electronic address: holger.moch@usz.ch.
² Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Urology, USC Keck School of Medicine, Los Angeles, CA, USA.
³ Barts Cancer Institute, Queen Mary University of London, London, UK; Department of Cellular Pathology, Barts Health NHS Trust, London, UK.
⁴ Department of Pathology, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria.
⁵ Sydney Medical School, University of Sydney, Sydney, Australia; NSW Health Pathology, Department of Anatomical Pathology and Pathology Group Kolling Institute of Medical Research Royal North Shore Hospital St Leonards, Sydney, Australia.
⁶ Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
⁷ Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
⁸ Histopathology and Molecular Diagnostics, University Hospital Careggi, Florence, Italy.
⁹ Department for BioMedical Research (DBMR), Bern Center for Precision Medicine (BCPM), University of Bern and Inselspital, Bern, Switzerland.
¹⁰ Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
¹¹ Division of Pathology, Singapore General Hospital, Singapore.
¹² Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
¹³ Department of Surgical Pathology, Aichi Medical University Hospital, Nagakut, Japan.
¹⁴ The Francis Crick Institute and The Royal Marsden NHS Foundation Trust, London, UK.
¹⁵ International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France.
¹⁶ Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.

PMID: 35853783
DOI: 10.1016/j.eururo.2022.06.016

Abstract

The fifth edition of the World Health Organization (WHO) classification of urogenital tumours (WHO "Blue Book"), published in 2022, contains significant revisions. This review summarises the most relevant changes for renal, penile, and testicular tumours. In keeping with other volumes in the fifth edition series, the WHO classification of urogenital tumours follows a hierarchical classification and lists tumours by site, category, family, and type. The section "essential and desirable diagnostic criteria" included in the WHO fifth edition represents morphologic diagnostic criteria, combined with immunohistochemistry and relevant molecular tests. The global introduction of massive parallel sequencing will result in a diagnostic shift from morphology to molecular analyses. Therefore, a molecular-driven renal tumour classification has been introduced, taking recent discoveries in renal tumour genomics into account. Such novel molecularly defined epithelial renal tumours include SMARCB1-deficient medullary renal cell carcinoma (RCC), TFEB-altered RCC, Alk-rearranged RCC, and ELOC-mutated RCC. Eosinophilic solid and cystic RCC is a novel morphologically defined RCC entity. The diverse morphologic patterns of penile squamous cell carcinomas are grouped as human papillomavirus (HPV) associated and HPV independent, and there is an attempt to simplify the morphologic classification. A new chapter with tumours of the scrotum has been introduced. The main nomenclature of testicular tumours is retained, including the use of the term "germ cell neoplasia in situ" (GCNIS) for the preneoplastic lesion of most germ cell tumours and division from those not derived from GCNIS. Nomenclature changes include replacement of the term "primitive neuroectodermal tumour" by "embryonic neuroectodermal tumour" to separate these tumours clearly from Ewing sarcoma. The term "carcinoid" has been changed to "neuroendocrine tumour", with most examples in the testis now classified as "prepubertal type testicular neuroendocrine tumour".

Keywords: Carcinoma; Classification; Kidney; Penis; Testis; World Health Organization.

Publication types

Review

MeSH terms

Carcinoma, Renal Cell* / pathology
Genitalia, Male / pathology
Humans
Kidney Neoplasms* / diagnosis
Male
Neoplasms, Germ Cell and Embryonal* / genetics
Neuroectodermal Tumors*
Papillomavirus Infections*
Receptor Protein-Tyrosine Kinases
Testicular Neoplasms* / pathology
World Health Organization

Substances

Receptor Protein-Tyrosine Kinases

Abstract

Publication types

MeSH terms

Substances

Grants and funding